A retrospective study of patients with colorectal polyps

Mohammad Javad Eshghi, Reza Fatemi, Asad Hashemy, David Aldulaimi, Mahsa Khodadoostan

Gastroenterology and Hepatology from Bed to Bench, Vol. 4 No. 1 (2011), 29 December 2010,

Aim: The aim of this study was to report the anatomical location and histologic type of colorectal polyps in a large series of Iranian patients that attended for colonoscopy.

Background: Polyps that develop through the adenoma-carcinoma pathway are considered neoplastic and may eventually progress to invasive carcinomas. In addition polyps can develop with no neoplastic potential. These neoplastic and non-neoplastic polyps can be identified and removed at colonoscopy.

Patients and methods: In this retrospective study, the medical records of patients who had attended for colonoscopy were reviewed. Patient demographics and colonoscopy findings were reviewed. The anatomical location, macroscopic appearance and histological assessment of any polyps were recorded.

Results: 716 patients' records were reviewed. 437 patients (61 %) were male and 279(39%) were females. The mean patient age was 55.3 yr (18-89 yr). A total of 936 polyps were identified. 779 (83.3%) were neoplastic and 157(16.7%) polyps were non-neoplastic.727 of the polyps were adenomatous. Of the 727 adenomatous polyps: 198(27.2%) were in sigmoid, 156(21.24%) were in caecum and ascending colon, 153(21%) were in descending colon, 131(18%) were in transverse colon and 89(12.3%) were in rectum. 39.5% of adenomas were proximal to the splenic flexure.  Carcinoma was observed in 52 cases. 18 carcinomas (34.5%) were left sided and 34 (65.5% of carcinomas) were right sided. Of the 716 patients, 179 patients (25%) had synchronous lesion(s).

Conclusion: A significant number of adenomas and carcinomas lie proximal to the splenic flexure and occur in the absence of distal lesions. These lesions would be missed if the distal colon was examined and the entire colon examined only if a distal lesion was identified.

Assessment the relationship between reflux and body mass index with comparing different regression models

Mohamad Amin Pourhoseingholi, Asma Pourhoseingholi, Bijan Moghimi-Dehkordi, Azadeh Safaee, Ali Solhpour

Gastroenterology and Hepatology from Bed to Bench, Vol. 4 No. 1 (2011), 29 December 2010,

Aim: The aim of this study was to determine whether there is relation between body mass index and symptoms of gastro-esophageal reflux disease in our community using Logit, Probit and Complementary log-log models.

Background: The most frequent statistical tool to address the relationship among a dichotomous response and other covariates is logistic regression. However logistic regression is familiar for researchers, some other models with similar results are favorable to assess such relationship like as Probit and Complementary log-log.

Patients and methods: We carried out a population-based study to estimate the strength of the association between body mass and reflux symptoms. During interview, participants completed a valid Gastro-esophageal Reflux Questionnaire. The coefficients calculated by logistic, Probit and Complementary log-log regression with multivariate adjustments for covariates.

Results: Reflux symptoms at least once a week over the last three months were reported by 522 (9.1%) of the 5733 interviewees. There were no evidence in all models to address the significant relation between Reflux and BMI and all models derived in same efficacy.

Conclusion: Our results showed that the choice of the link function in this analysis is not the most important issue but still a user could also look forward to some other link functions like Probit and Complementary log-log.

Genotyping of Cryptosporidium spp. in clinical samples: PCR-RFLP analysis of the TRAP-C2 gene

Ehsan Nazemalhosseini Mojarad, Akbar Keshavarz, Niloofar Taghipour, Ali Haghighi, Bahram Kazemi, Amid Athari

Gastroenterology and Hepatology from Bed to Bench, Vol. 4 No. 1 (2011), 29 December 2010,

Aim: The aim of the present study was to determine the species and genotypes of Cryptosporidium spp. among children with diarrhea by PCR- RFLP using the TRAP-C2 gene.

Background: Cryptosporidium is a globally distributed protozoan parasite and one of the most common causes of infection and diarrhea in humans.

Patients and methods: Four hundred and sixty nine stool samples were collected from children less than 12 years with diarrhea who had been referred to Pediatrics Medical Centers in Gazvin provinces. The presence of Cryptosporidium oocysts was determined by Ziehl-Neelsen acid fast staining, then, genomic DNA was extracted from positive samples and nested PCR-RFLP was performed to amplify the TRAP-C2 gene.

Results: The overall prevalence of Cryptosporidium infection in children was 2.5 %. Results of nested PCR amplification showed that of 12 positive children samples, 10 (83.3%) were belonged to C. parvum, followed by C. hominis in 1 (8.3%) and mixed infection in 1 isolate (8.3%).

Conclusion: This study showed that Cryptosporidium parvum (the zoonotic genotypes) is more prevalent than other Cryptosporidium species in children from this area. This suggests that zoonotic transmission is the main mode of transmission of Cryptosporidium infection in Iran.

The evaluation of interleukin-8 chemokine in chronic and acute Toxoplasma gondii infection

Mohammad Rostami Nejad, Somayeh Jahani Sherafat, Mohammad Roshani, Mohammad Telkabadi, Farhad Lahmi, Kourosh Cheraghipour, Ali Reza Kaboli, Mostafa Alavi-Moghaddam

Gastroenterology and Hepatology from Bed to Bench, Vol. 4 No. 1 (2011), 29 December 2010,

Aim: We investigated whether the level of IL8 was different in patients with chronic and acute Toxoplasma gondii infection during the pregnancy compared with control group.

Background: It is well established that T.gondii infection induces a strong cell-mediated immune response.

Patients and methods: ELISA was used to determine the level of IL8 in sera of 568 pregnant women. Patients were divided into three groups according to a T.gondii serology.  The first group included 202 women with positive IgG titres, the second group was 66 women with IgM and negative IgG T.gondii serology; and the third group comprised the sera of 300 healthy pregnant women with negative T.gondii serology and served as controls.

Results: The level of IL8 in group I was within normal range similar to control group. However, the level of IL8 was increased in those pregnant patients with positive IgM T.gondii serology.

Conclusion: The serum levels of pro-inflammatory cytokines such as IL8 seem to be increased in patients with serological evidence of acute T.gondii infection. 

Review Article

Facing resistance of H.pylori infection

Mohammad Reza Zali

Gastroenterology and Hepatology from Bed to Bench, Vol. 4 No. 1 (2011), 29 December 2010,

Helicobacter pylori is an important human pathogen and a gram-negative, spiral shaped and microaerophilic bacteria with persistence colonization in gastric mucosa, causes gastroduodenal inflammation and destruction, resulting in diseases such as duodenal ulcer disease, gastric ulcer disease. When H.pylori discovered by Warren and Marshall, effective therapy developed for this infection and resulted in remarkable change in management of PUD and dyspepsia. Nowadays, the increasing prevalence of drug resistance has complicated successful therapy, considering more attention for appropriate therapy. Ideally, therapy should be based on pretreatment drug susceptibility testing, and empiric use of eradication therapies should assume the presence of antimicrobial drug resistance and use increased doses for 14 days.

Medical Education

Letter to Editor